Prevalence of Chronic Obstructive Pulmonary Disease in Patients Diagnosed with Cerebrovascular Accidents and Its Effect on Health Care Utilization: A Cross-sectional Study

J Stroke Cerebrovasc Dis. 2020 Feb;29(2):104553. doi: 10.1016/j.jstrokecerebrovasdis.2019.104553. Epub 2019 Dec 11.


Background: To assess prevalence and to determine the impact of chronic obstructive pulmonary disease (COPD) on health care utilization in patients with cerebrovascular accident (CVA).

Methods: We performed retrospective analysis of data from 12,102 patients who had diagnosis of CVA from 2014 to 2019 at tertiary medical center. We calculated the prevalence of COPD among patients with diagnosis of CVA. We performed unadjusted, covariate adjusted, and propensity-matched analysis to evaluate differences in health care utilization in patients with CVA and COPD compared to patients with CVA without COPD.

Results: 12,102 patients were diagnosed with CVA episodes. The prevalence of COPD among CVA patients was 7.65 % (95%CI: 7.18-8.13). The unadjusted and covariate adjusted analysis demonstrated that the average number of hospitalizations among CVA patients with a diagnosis of COPD was significantly higher than CVA patients without COPD. After adjusting for modifiable and nonmodifiable confounders, CVA patients diagnosed with COPD have on average 1 more hospitalization (1.21; 95%CI: 1.12-1.30) than those who are not diagnosed with COPD. Subsequent analysis based on propensity-matched data suggests that CVA patients diagnosed with COPD have on average approximately 1 more hospitalization (1.44; 95% CI: 1.31-1.58) than CVA patients without COPD.

Conclusions: Our study suggests significant prevalence of COPD among CVA patients. The presence of COPD as a comorbidity resulted in patients with COPD and CVA having increased number of hospitalizations compared to CVA patients without COPD.

Keywords: Cerebrovascular disease; chronic obstructive pulmonary disease; comorbidity; health service utilization; prevalence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arkansas / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / therapy
  • Tertiary Care Centers